The value of frontal assessment battery in stroke patients

Abstract

The aim of this study is to evaluate the value of Frontal Assessment Battery (FAB) compared with Mini-Mental State Examination (MMSE) for detecting frontal lobe dysfunction and evaluate the correlations between FAB and neurocognitive function test. Medical records of stroke patients underwent cognitive assessment including the FAB and MMSE were retrospectively reviewed and the patients divided into three groups; lesions involving frontal lobe cortex, lesions related with frontal subcortical circuit and other lesion groups. We compared the FAB and MMSE scores, especially frontal lobe function domain among these groups. A total of 186 patients with frontal lobe lesion had significantly lower total FAB score compared to other lesions with frontal subcortical circuit. In correlation with neurocognitive function test, FAB scores were more correlated with measures of high cognitive function and memory tests, such as trail making test A, card sorting test, digital span and visual span, than MMSE. Even after controlling MMSE scores, FAB scores were correlated with trail making test A, digital span and visual span tests. In scatterplots, there was a positive correlation between MMSE and FAB scores. When divided group by median MMSE score, high MMSE score group showed lower correlation with FAB compared to low MMSE score group ( Fig. 1 ). FAB showed better correlation with other frontal lobe function tests than MMSE, especially executive and memory functions domains. The FAB scores were proportional to MMSE scores and this correlation was more prominent in low MMSE score group. In patients with high MMSE scores, there may also be frontal dysfunction that cannot be detected with the MMSE score, therefore additional FAB testing should be performed. The FAB has screening value for frontal lobe function added to MMSE and can be used in clinical to detect cognitive impairment more specifically.